Provider Demographics
NPI:1154462265
Name:HOFFMAN, ANDREW J (PHD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23210 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5462
Mailing Address - Country:US
Mailing Address - Phone:216-464-0383
Mailing Address - Fax:216-491-8018
Practice Address - Street 1:23210 CHAGRIN BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5462
Practice Address - Country:US
Practice Address - Phone:216-464-0383
Practice Address - Fax:216-491-8018
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2066103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical